ANZCTR search results

In this study, we are interested in the effects of mental health nursing on patient outcomes. A mental health nurse has had special training in how to care for people who are mentally unwell. Our study aim is to find out if it is possible to use routine health data to test if there is a link between the amount of mental health nurse care patients get and the chance of them have a relapse after they leave the hospital.

The purpose of this study is to evaluate a diagnostic blood test (C-reactive protein) to detect infection and inflammation in the first 3-5 days following bowel surgery. Who is it for? You may eligible for this study if you are 18 years or older and undergoing elective colonic or rectal resection with a primary anastomosis at Lyell McEwin Hospital. Study details Patients enrolled in the study will be allocated into two groups, the control and intervention group. Participants in the control group will be monitored via standard care protocols at the hospital. The intervention group will have a blood test with a small needle in the arm on days 3, 4 and 5 after surgery. If the CRP value is above certain thresholds on these days, a 'septic screen' will be performed to look for a source of infection. The assessments that you may be involved in include, a CT scan, chest x ray, wound swab and urine/blood tests. It is hoped this research will help determine if using a clinical protocol based on the CRP to perform an infection screen will allow earlier detection of infectious complications following major colorectal surgery. It is hoped this will also allow for earlier intervention and treatment.

Older patients undergoing surgery are at an increased risk of post-operative complications including geriatric syndromes such as delirium, functional decline and falls.. The Aged Care Department at Concord Hospital will introduce a novel co-management model of care for older adults admitted under the vascular surgery service. As part of the new service proactive comprehensive geriatric assessment and management will be undertaken by the geriatrician who will work collaboratively with the vascular surgery nursing staff and team. Using a prospective before and after study design, this research will evaluate the impact of this innovative, interdisciplinary and patient-centred model of care on important health outcomes.

Currently the gold-standard treatment for PTSD is prolonged exposure therapy (PE), however, despite robust evidence of the efficacy of PE, approximately 40% of those completing the treatment show only partial or no treatment response, therefore, it is critical to advance the field to identify new ways to facilitate treatment response to PE. Research suggests that a neuropeptide, Brain derived Neurotrophic Factor (BDNF), can improve the main mechanism underlying the PE treatment in PTSD and a well-validated way to increase BDNF levels is through acute moderate intensity (aerobic) exercise. This project aims to investigate whether combining a 20-minute aerobic exercise intervention with PE treatment to increase BDNF levels during therapy would increase the effectiveness of PE treatment in PTSD. We hypothesise that the treatment response will be greater in PTSD patients receiving aerobic exercise intervention with PE treatment compared to control group of PTSD patients receiving a 20-minute gentle stretching with PE treatment and this effect will be mediated by the exercise induced changes in BDNF levels.

Frail older persons are at high risk of hospitalization due to acute events associated with chronic diseases. The combination of frailty, functional deterioration, and acute conditions substantially increase the risk of falling, and hence the likelihood of incurring a fall-related injury. Those injuries (i.e. fractures, soft tissue trauma, residual pain, etc.) not only have devastating consequences on an individual's quality of life but may also affect a hospital's reputation in the community. In addition, hospitals may face litigation claims and increased costs for patients who fall and suffer a major injury as a consequence. External hip protectors are comparable to padded undergarments and shield the trochanter, reducing the detrimental effects and force impacting the bone during a fall. Screening for patients at high risk of falling and providing high-risk patients with hip protectors as a preventive measure to avoid hip fractures and other fall-related injuries, not only improves public health, but can also save hospitals care and litigation costs. It has also been demonstrated to be a cost-effective intervention. However, the acceptance of hip protectors by frail older persons and those factors affecting in-hospital adherence remain unknown. This study will aim to assess the tolerability and acceptability of hip protectors and the prevention of fall-related injuries in hospitalised frail older persons.

StandingTall targets a major need for older people for whom falls are a real risk that can have debilitating impacts on quality of life. This project aims to evaluate the implementation of StandingTall in clinical practice and the community in multiple sites across Australia and Northern England. We will monitor exercise adherence, as well as acceptability and uptake of StandingTall in older people and health care workers. Our primary aim is to estimate mean adherence at each site with a confidence interval width of +/- 10 minutes. This project addresses the final steps needed to disseminate this innovative technology for widespread use by older people across Australia, UK and internationally.

The Problem: After the initial brain trauma (primary injury) additional brain injury occurs (secondary brain injury) which can significantly affect long-term outcomes of death and severe disability. We aim to reduce this secondary brain injury through a strategy of brain oxygen neuromonitoring and optimisation. Clinical monitoring has traditionally focused on measuring intracranial pressure (ICP), and optimising cerebral perfusion pressure (CPP). These are both insensitive to changes in brain oxygen. Neuronal health depends on a constant supply of oxygen, and in patients with the worst outcomes, brain ischemia is found. In comparison to standard ICP/CPP based care, the BONANZA study will assess the value of additional continuous monitoring of the partial pressure of brain tissue oxygen (PbtO2), in combination with a specific set of interventions that can be instituted when low brain oxygen levels are detected. Some centres use this approach as standard, but this number is currently small. Current data suggests this approach reduces the cerebral hypoxic burden post-TBI and may improve survival and functional outcomes. The solution: The BONANZA study will assess this management strategy and guide clinical practice and policy globally with significant impacts whether the approach proves beneficial or not. This study has now become truly global with sites in Australia, New Zealand, Switzerland, Belgium, UK, Finland, Spain, France and Germany. The Impact: If BONANZA demonstrates benefit, it will become the global standard of care benefiting patients, their families, clinicians and reducing healthcare costs. Equipoise currently exists to address this important evidence gap.

KT-101-02 is a multi-centre, randomised, double-masked, exploratory study of topical ocular miotic agents when administered as a microdose with the Kedalion AcuStream™ delivery system to improve symptoms of presbyopia. Pre-clinical testing evaluation and previous clinical trials show that miotics delivered through the AcuStream™ device have shown efficacy and safety for the treatment of presbyopia. This study will further define the efficacy benefits as well as tolerability and side effects.

The purpose of this study is to see if a medication called anamorelin improves muscle mass and outcomes in patients with malignant mesothelioma. Who is it for? You may be eligible for this study if you are aged 18 or over, have confirmed malignant mesothelioma and have lost more than 5% of your body weight in 6 months (i.e. ‘cachexia’). Study details Participants will be randomised by chance (like flipping a coin) into two groups. One group will take the active drug anamorelin per day for 28 days, before switching to an inactive placebo medication for another 28 days (after a 3 day break). The other group will follow the same pattern, only they will have the placebo first and then the active medication. Neither the researchers nor participants will know which order the medication/placebo are taken in. As part of this study, all participants will complete a number of questionnaires, a food diary, provide blood samples for testing and have body scans that measure muscle mass. It is hoped this research will show that the medication anamorelin can help patients with malignant mesothelioma maintain or gain weight, which might help them feel better, and shed some insight into body markers of cancer-related weight-loss.

Vaccination against pertussis whooping cough and influenza are recommended during pregnancy to protect both the mother and baby from these diseases. A group of medications called biological disease-modifying antirheumatic drugs (bDMARDs) are increasingly being used in pregnant women in autoimmune diseases, and the impact of these medications on the immune response to vaccines in mothers and in their babies is not yet known. We hypothesise that the immune response to some vaccines may be lower in babies who were exposed to these medications during pregnancy. We will compare the immune response to vaccines in mothers and babies in four groups; women who took bDMARDs during pregnancy; women who took other types of immune-suppressing medications; women who have autoimmune disease but did not take any immune-suppressing medications during pregnancy; and healthy pregnant women.